{"uin":"ZUNHLIP23204V012223","name":"Zuno Empower Health","url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223","insurer":{"slug":"zuno-general-insurance","name":"Zuno General Insurance Ltd","url":"https://indiainsurances.com/insurer/zuno-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Zuno Empower Health is an individual indemnity and benefit health policy for persons with disability and individuals with HIV/AIDS. It offers sum insured options of 4 lacs and 5 lacs, with 20% co-payment on all claims unless the co-pay waiver is opted and paid for.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:55:35.123188+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named plan variants inside the product are stated.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1 Year","display":"1 Year","note":null,"quote":"Policy Period | 1 Year","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For emergency hospitalisation, notice with full particulars must be sent within 24 hours from the date emergency hospitalization is required or before discharge, whichever is earlier. For planned hospitalisation, notice must be sent at least 48 hours before admission.","display":"Emergency: within 24 hours or before discharge, whichever is earlier; planned: at least 48 hours before admission","note":null,"quote":"Notice with full particulars shall be sent to the Company/TPA (if applicable) as under: i. Within 24 hours from the date of emergency hospitalization required or before the Insured Person’s discharge from Hospital, whiche earlier. ii. At least 48 hours prior to admission in Hospital in case of a planned Hospitalization.","sources":[{"clause":"15(II)(b)(vi)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-vi"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly Completed claim form","Photo Identity proof of the patient","Medical practitioner's prescription advising admission","Original bills with itemized break-up","Payment receipts","Discharge summary including complete medical history of the patient along with other details","Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner","OT notes or Surgeon's certificate giving details of the operation performed (for surgical cases)","Sticker/invoices of the Implants, wherever applicable","MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, wherever applicable","NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque","KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines","Legal heir/succession certificate, wherever applicable","Any other relevant document required by Company/TPA for assessment of the claim"],"display":"Claim form, ID proof, prescription, original itemised bills, receipts, discharge summary, investigation reports, OT notes, implant invoices, MLR/FIR if applicable, NEFT/cancelled cheque, KYC above Rs 1 Lakh, legal heir certificate if applicable, and other relevant documents","note":null,"quote":"i. Duly Completed claim form. ii. Photo Identity proof of the patient iii. Medical practitioner's prescription advising admission. iv. Original bills with itemized break-up ... v. Payment receipts\nvi. Discharge summary including complete medical history of the patient along with other details. ... vii) Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner ... viii) OT notes or Surgeon's certificate giving details of the operation performed (for surgical cases). ... ix) Sticker/invoices of the Implants, wherever applicable. ... x) MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, wherever applicable. ... xi) NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque. ... xii) KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines ... xiii) Legal heir/succession certificate, wherever applicable ... xiv) Any other relevant document required by Company/TPA for assessment of the claim.","sources":[{"clause":"15(II)(b)(vi)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-vi"},{"clause":"15(II)(b)(vii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-vii"},{"clause":"15(II)(b)(viii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-viii"},{"clause":"15(II)(b)(ix)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-ix"},{"clause":"15(II)(b)(x)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-x"},{"clause":"15(II)(b)(xi)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xi"},{"clause":"15(II)(b)(xii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xii"},{"clause":"15(II)(b)(xiii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiii"},{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a non-cashless claim within 15 days from receipt of the last necessary document. If investigation is needed, it must complete investigation not later than 30 days from the last necessary document and settle or reject the claim within 45 days from that date.","display":"15 days from last necessary document; 45 days if investigation is needed","note":"Interest at 2% above the bank rate is payable for delay as stated in the policy.","quote":"The Company shall settle or reject a claim as the case may be, 15 days (other than cashless) from the date of receipt of last necessary document. ... where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"15(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-3"},{"clause":"15(iii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases","First 30 days waiting period","Specified disease/procedure waiting period","Investigation & Evaluation","Rest Cure, rehabilitation, and respite care","Change-of-Gender treatments","Cosmetic or plastic Surgery","Hazardous or Adventure sports","Breach of law","Unproven Treatments","Sterility and Infertility","Maternity","Any medical treatment taken outside India","Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs","Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization"],"display":"Waiting periods for PED, first 30 days and specified diseases, plus exclusions including investigation, rest cure, gender change, cosmetic surgery, adventure sports, breach of law, unproven treatments, infertility, maternity, treatment outside India, organ donation and OPD/domiciliary expenses","note":null,"quote":"Pre-Existing Diseases (Code- Excl01) ... First 30 days waiting period- Code- Excl03 ... Specified disease/procedure waiting period- Code- Excl02 ... Investigation & Evaluation- Code- Excl04 ... Rest Cure, rehabilitation, and respite care- Code- Excl05 ... Change-of-Gender treatments: Code- Excl07 ... Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... Any medical treatment taken outside India. ... Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs. ... Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl01"},{"clause":"Excl03","heading":"First 30 days waiting period- Code- Excl03","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl03"},{"clause":"Excl02","heading":"Specified disease/procedure waiting period- Code- Excl02","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl02"},{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation, and respite care- Code- Excl05","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl05"},{"clause":"Excl07","heading":"Change-of-Gender treatments: Code- Excl07","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl09"},{"clause":"Excl10","heading":"Breach of law","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl10"},{"clause":"13","heading":"Unproven Treatments","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-13"},{"clause":"14","heading":"Sterility and Infertility","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-14"},{"clause":"15","heading":"Maternity: Code Excl18","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15"},{"clause":"15(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii"},{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-d"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First submit the grievance in writing to the policy issuing office or regional office. If not satisfied, contact customer service, then the Grievance Cell, then the Grievance Redressal Officer before IRDAI/Bima Bharosa and Ombudsman escalation.","display":"Policy issuing office or regional office first; then customer service, Grievance Cell and Grievance Redressal Officer","note":null,"quote":"Grievance—In case of any grievance relating to servicing the Policy, the insured person may submit in writing to the Policy issuing office or regional office for redressal. ... Escalation Level 1 For lack of a response or if the resolution still does not meet your expectations, you can contact our Grievance Cell on 1800-120-216216 or write to grievance@hizuno.com . ... Escalation Level 2 For lack of a response or if the resolution still does not meet your expectations, you can write to the Grievance Redressal Officer at grievanceofficer@hizuno.com or call us at 022-42312022","sources":[{"clause":"15(I)(b)(v)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-v"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"4 lacs and 5 lacs","display":"4 lacs and 5 lacs","note":null,"quote":"Sum insured available(in INR) | 4 lacs and 5 lacs","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"The table also states: Initial Waiting period | 30 days for all claims except resulting from Accident.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"Excl03","heading":"First 30 days waiting period- Code- Excl03","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl03"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months; 24 months for pre-existing disability","note":"PED cover is subject to the condition that the disease was declared at application and accepted by the insurer.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months for pre-existing disability / 36 months for all pre-existing disabilities other than HIV/AIDS and Disability (as mentioned in Policy Schedule) of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"Excl01(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl01-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"This exclusion does not apply for claims arising due to an accident.","quote":"Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 24 months as (mentioned in Policy Schedule) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"Excl02(a)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl02-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps","Benign prostate hypertrophy","Cataract and age-related eye ailments","Gastric/ Duodenal Ulcer","Gout and Rheumatism","Hernia of all types","Hydrocele","Non-Infective Arthritis","Piles, Fissures and Fistula in anus","Pilonidal sinus, Sinusitis and related disorders","Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident","Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy","Varicose Veins and Varicose Ulcers"],"display":"Listed 24-month conditions include ENT disorders, tonsillectomy, adenoidectomy, mastoidectomy, tympanoplasty, hysterectomy, benign tumours/cysts/polyps, BPH, cataract, ulcers, gout/rheumatism, hernia, hydrocele, arthritis, piles/fissures/fistula, pilonidal sinus/sinusitis, spinal diseases, calculi and varicose veins/ulcers","note":null,"quote":"24 Months waiting period.\n1. Benign ENT disorders | 12. Hernia of all types\n2. Tonsillectomy | 13. Hydrocele\n3. Adenoidectomy | 14. Non-Infective Arthritis\n4. Mastoidectomy | 15. Piles, Fissures and Fistula in anus\n5. Tympanoplasty | 16. Pilonidal sinus, Sinusitis and related disorders\n6. Hysterectomy | 17. Prolapse inter Vertebral Disc and Spinal Diseases unless arising\n7. All internal and external benign tumors, cysts, polyps of any | from accident.\nkind, including benign breast lumps. | 18. Calculi in urinary system, Gall Bladder and Bile duct, excluding\n8. Benign prostate hypertrophy | malignancy.\n9. Cataract and age-related eye ailments | 19. Varicose Veins and Varicose Ulcers\n10. Gastric/ Duodenal Ulcer\n11. Gout and Rheumatism","sources":[{"clause":"Excl02(e)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl02-e"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"years","amount":5},"display":"five continuous years","note":"After the expiry of Moratorium Period no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","quote":"After completion of five continuous years under the policy no look back to be applied. This period of five years is called as moratorium period.","sources":[{"clause":"15(I)(b)(v)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-v"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person has the option to port the policy to other insurers as per extant portability guidelines and can get accrued continuity benefits in waiting periods if continuously covered without lapses.","display":"Can port to other insurers with accrued continuity benefits in waiting periods","note":"Portability benefit applies to the extent of previous sum insured and accrued bonus and not to other additional increased Sum Insured.","quote":"The Insured Person will have the option to port the Policy to other insurers as per extant Guidelines related to portability, If such person is presently covered and has been continuously covered without any lapses under any health insurance plan with an Indian General/Health insurer as per Guidelines on portability, the proposed Insured Person will get all the accrued continuity benefits in waiting periods","sources":[{"clause":"15(I)(b)(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-iii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The policy says it is ordinarily renewable, but does not state lifelong renewal or no maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"not-stated","value":null,"display":null,"note":"The policy states renewal shall not be denied because claims were made, but does not state whether premium loading after claims can or cannot apply.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Excl04 Investigation & Evaluation","Excl05 Rest Cure, rehabilitation, and respite care","Excl06 Obesity/ Weight Control","Excl07 Change-of-Gender treatments","Excl08 Cosmetic or plastic Surgery","Excl09 Hazardous or Adventure sports","Excl10 Breach of law","Excl11 Excluded Providers","Excl12 Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Excl13 Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Excl14 Dietary supplements and substances that can be purchased without prescription","Excl15 Refractive Error","Excl16 Unproven Treatments","Excl17 Sterility and Infertility","Excl18 Maternity","Any medical treatment taken outside India","Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs","Anti-Retroviral Treatment cost under HIV/AIDS cover","Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization","Stem cell storage"],"display":"Permanent exclusions include standard exclusions Excl04 to Excl18 and product exclusions such as treatment outside India, organ donation hospitalisation, ART cost, OPD/domiciliary expenses and stem cell storage","note":null,"quote":"Excl04 Investigation & Evaluation- Code- Excl04 ... Excl05 Rest Cure, rehabilitation, and respite care- Code- Excl05 ... Excl06 Obesity/ Weight Control: Code- Excl06 ... Excl07 Change-of-Gender treatments: Code- Excl07 ... Excl08 Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Excl11 Excluded Providers: Code- Excl11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... Code- Excl13 ... Dietary supplements and substances that can be purchased without prescription ... Code- Excl14. ... Refractive Error: Code- Excl15 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... Any medical treatment taken outside India. ... Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs. ... This cover will exclude cost for any Anti-Retroviral Treatment. ... Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered. ... Stem cell storage.","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation, and respite care- Code- Excl05","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: Code- Excl07","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl09"},{"clause":"Excl10","heading":"Breach of law","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl10"},{"clause":"Excl11","heading":"Excluded Providers: Code- Excl11","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-excl11"},{"clause":"9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-9"},{"clause":"10","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-10"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-11"},{"clause":"12","heading":"Refractive Error","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-12"},{"clause":"13","heading":"Unproven Treatments","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-13"},{"clause":"14","heading":"Sterility and Infertility","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-14"},{"clause":"15","heading":"Maternity: Code Excl18","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15"},{"clause":"15(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii"},{"clause":"7","heading":"Specific Conditions Applicable For Persons With HIV-AIDS","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-7"},{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-d"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The insured may cancel by giving 7 days' written notice. For policy term up to one year, the Company refunds proportionate premium for the unexpired period if no claim has been made; no refund is made where any claim has been admitted, lodged or any benefit availed.","display":"7 days' written notice; proportionate premium for unexpired period if term up to one year and no claim","note":null,"quote":"The Insured may cancel this Policy by giving 7days' written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period as per the rates detailed below ... refund proportionate premium for unexpired policy period, if the term of policy up to one year and there is no claim (s) made during the policy period. ... no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by You under this Policy.","sources":[{"clause":"15(I)(e)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-e"},{"clause":"15(I)(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-a-2"},{"clause":"15(I)(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"India only, because any medical treatment taken outside India is excluded.","display":"India only","note":"The quoted words appear under Specific Exclusions.","quote":"Any medical treatment taken outside India.","sources":[{"clause":"15(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days","note":"Applicable on new individual health insurance policies and not on renewals.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"15(I)(b)(v)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-v"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for quarterly, half-yearly and yearly; 15 days for monthly","note":"For monthly premium payment, the grace period is 15 days.","quote":"Grace Period | For quarterly, half- yearly and Yearly payment of mode, a fixed period of 30 days is to be allowed as Grace. Period and for monthly modes of payment a fixed period of 15 days be allowed as grace period.","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Adults: 18 years to 65 years. Children: Newborn to 17 years.","display":"Adults 18 years to 65 years; Children Newborn to 17 years","note":"The product is for persons with disability with valid disability certificate and individuals with HIV/AIDS.","quote":"Age eligibility for adults: 18 years to 65 years • Age eligibility for Children: Newborn to 17 years","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Annual","Half Yearly","Quarterly","Monthly"],"display":"Annual, Half Yearly, Quarterly or Monthly","note":null,"quote":"Payment of Premium on an instalments basis i.e. Half Yearly, Quarterly or Monthly ... thirty days (where premium is paid in quarterly/halfyearly/annual instalments)","sources":[{"clause":"15(I)(b)(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-iii"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["waiver for Co-pay"],"display":"Waiver for Co-pay, if opted and premium is paid","note":null,"quote":"Co-payment | 20% on all claims made under the policy unless waiver for Co-pay is opted and premium is paid for the same","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"At renewal, coverage is not available during the grace period. If premium is paid in instalments during the policy period, coverage will be available for the grace period also.","display":"No cover during renewal grace period; cover available during instalment grace period","note":null,"quote":"Coverage is not available during the grace period. ... If the premium is paid in instalments during the policy period, coverage will be available for the grace period also","sources":[{"clause":"15(I)(b)(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i-b-iii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room Rent, Boarding and Nursing Expenses are covered up to 1% of the Sum Insured, subject to a maximum of Rs.5000 per day.","display":"1% of Sum Insured, maximum Rs.5000 per day","note":null,"quote":"Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 1% of the Sum Insured subject to maximum of Rs.5000/ per day.","sources":[{"clause":"4.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-1"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"No room category such as shared or single private room is stated; the policy uses a room rent amount limit.","display":"No room category stated; room rent amount limit applies","note":null,"quote":"Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 1% of the Sum Insured subject to maximum of Rs.5000/ per day.","sources":[{"clause":"4.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-1"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU/ICCU expenses are covered up to 2% of the Sum Insured, subject to a maximum of Rs.10,000 per day.","display":"2% of Sum Insured, maximum Rs.10,000 per day","note":null,"quote":"Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses up to 2% of Sum Insured subject to maximum of Rs.10,000/- per day.","sources":[{"clause":"4.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-1"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":"The policy defines associated medical expenses for cases of room rent higher than entitled room rent limit, but does not state a proportionate deduction formula.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Each and every claim is subject to a co-payment of 20% of the admissible and payable claim amount. The table says this applies on all claims unless waiver for Co-pay is opted and premium is paid.","display":"20% on all claims unless waiver for Co-pay is opted and premium is paid","note":null,"quote":"Each and every claim under the policy shall be subject to a co-payment of 20% applicable to claim amount admissible and payable as per the terms and conditions of the policy. ... Co-payment | 20% on all claims made under the policy unless waiver for Co-pay is opted and premium is paid for the same","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"No deductible amount or basis is stated.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract Treatment: 25% of Sum Insured or Rs.40,000/-, whichever is lower, per each eye in one policy year"],"display":"Cataract: 25% of Sum Insured or Rs.40,000 per eye per policy year, whichever is lower","note":null,"quote":"The company shall indemnify medical expenses incurred for treatment of Cataract, subject to a limit of 25% of Sum Insured or Rs.40,000/-, whichever is lower, per each eye in one policy year.","sources":[{"clause":"4.6","heading":"Cataract Treatment","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-6"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Pre-hospitalization Medical Expenses can be claimed on a reimbursement basis only.","quote":"The Company shall indemnify Pre-Hospitalization Medical Expenses incurred, related to an admissible Hospitalization requiring Inpatient care, for a fixed period of 30 days prior to the date of admissible Hospitalization covered under the Policy during the policy period.","sources":[{"clause":"4.3","heading":"Pre-Hospitalization Medical Expenses","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-3"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":"Post-hospitalization Medical Expenses can be claimed on a reimbursement basis only.","quote":"The Company shall indemnify Post Hospitalization Medical Expenses incurred, related to an admissible Hospitalization requiring Inpatient Care, for a fixed period of 60 days from the date of discharge from the Hospital, following an admissible hospitalization covered under the Policy during the policy period.","sources":[{"clause":"4.4","heading":"Post-Hospitalization Medical Expenses","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-4"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"All day care treatments are covered. The policy also includes an indicative list of day care procedures in Annexure III.","display":"All day care treatments","note":null,"quote":"All day care treatments ... Time limit of 24 hrs shall not apply in respect of Day Care Treatment. ... ANNEXURE III – INDICATIVE LIST OF DAY CARE PROCEDURES","sources":[{"clause":"4.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-1"},{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"},{"clause":null,"heading":"List Ill - Items that are to be subsumed into Procedure Charges","page":21,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-list-ill-items-that-are-to-be-subsumed-into-proc"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalization expenses are not covered.","display":"Not covered","note":null,"quote":"expenses related to Domiciliary hospitalization shall not be covered.","sources":[{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-d"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems is covered up to the sum insured as specified in the policy schedule in any AYUSH Hospital.","display":"Covered up to sum insured in any AYUSH Hospital","note":null,"quote":"The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to sum insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"4.2","heading":"AYUSH Treatment","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Modern methods of treatment authorised by the Indian Medical Council or any other competent and authorised body are covered up to the Sum Insured, subject to policy terms, conditions, coverages, waiting periods and exclusions.","display":"Covered up to the Sum Insured","note":"The table of benefits in the same document says: Modern Treatment | Covered for listed procedures upto 50% of sum Insured available for inpatient hospitalization care.","quote":"We will cover all modern methods of treatment authorised by the Indian Medical Council or any other competent and authorised body from time to time up to the Sum Insured, subject to the policy terms, conditions, coverages, waiting periods and exclusions","sources":[{"clause":"4.7","heading":"Modern Treatment","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-7"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"Hospitalization for donation of body organs by an insured, including complications from donation, is excluded.","display":"Not covered","note":"The quoted words appear under Specific Exclusions.","quote":"Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs.","sources":[{"clause":"15(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance expenses are reimbursed up to a maximum of Rs.2000 per hospitalisation when the same hospitalisation claim is accepted. Air ambulance cover is not stated.","display":"Road ambulance up to Rs.2000 per hospitalisation","note":null,"quote":"Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalisation.","sources":[{"clause":"4.5","heading":"Emergency Ground Ambulance","page":8,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-4-5"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":"No restoration or refill of sum insured is stated.","quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":"No no-claim bonus or cumulative bonus is stated.","quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Non-payable items in Annexure II are not covered. The list includes items such as GLOVES and MASK.","display":"Non-payable items not covered, including GLOVES and MASK","note":null,"quote":"Non-Payable items: The expenses that are not covered in this Policy are placed under List-I of Annexure-II. ... 56 | GLOVES ... 60 | MASK","sources":[{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-d"},{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity medical expenses traceable to childbirth are excluded except ectopic pregnancy. Miscarriage expenses are excluded unless due to an accident, as are lawful medical termination expenses during the policy period.","display":"Not covered except ectopic pregnancy; miscarriage only if due to accident","note":null,"quote":"Maternity: Code Excl18 ... Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. ... Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":"15","heading":"Maternity: Code Excl18","page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15"},{"clause":"15(i)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-i"},{"clause":"15(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"Children are eligible from Newborn to 17 years. No separate newborn baby benefit is stated.","display":"Children: Newborn to 17 years","note":"The policy defines New born Baby as baby born during the Policy Period and aged up to 90 days, but no separate newborn benefit is stated.","quote":"Age eligibility for Children: Newborn to 17 years","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"Mental Illness is one of the disabilities for which the policy is specially designed. For persons with disability, treatment arising due to the pre-existing disability is covered only for Life-threatening Emergency Care and has a 24-month waiting period.","display":"Covered as an eligible disability; pre-existing disability treatment limited to Life-threatening Emergency Care after 24 months","note":null,"quote":"This policy is specially designed for. A. Covering Persons with Disability as per The Rights of Persons with Disabilities Act, 2016. ... 15. Mental Illness ... The Company will indemnify reasonable and customary charges for Life-threatening Emergency Care only, that are incurred by the Insured Person towards Inpatient Hospitalisation arising due to the pre-existing disability covered ... Any treatment for the pre-existing disability covered, will have a waiting period of 24 months from the first policy inception date.","sources":[{"clause":"1","heading":"Preamble","page":2,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-1"},{"clause":"6","heading":"Specific Conditions Applicable For Persons With Disability","page":9,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"No preventive health check-up benefit is stated.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Outpatient diagnostic, medical and surgical procedures or treatments are not covered.","display":"Not covered","note":null,"quote":"Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered.","sources":[{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-d"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":"No zone or city-based premium or treatment co-pay is stated.","quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless treatment may be taken at a network provider, subject to preauthorization by the Company or its authorised TPA. If cashless access is denied, the insured may take treatment and submit documents for reimbursement.","display":"Available at network providers subject to Company/TPA preauthorization","note":null,"quote":"Treatment may be taken in a network provider and is subject to preauthorization by the Company or its authorized TPA, ... The Company/ TPA upon getting cashless request form and related medical information from the insured person/ network provider will issue pre-authorization letter to the hospital after verification. ... ln case of denial of cashless access, the insured person may obtain the treatment as per treating doctor's advice and submit the claim documents to the Company / TPA for reimbursement.","sources":[{"clause":"15(II)(b)(ii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-ii"},{"clause":"15(II)(b)(iii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-iii"},{"clause":"15(II)(b)(vi)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-vi"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims servicing may be done by the Company or TPA for cashless preauthorization and processing of reimbursement claims, but TPA services do not include claim settlement and claim rejection.","display":"Company/TPA for servicing; claim settlement and rejection not by TPA","note":null,"quote":"Treatment may be taken in a network provider and is subject to preauthorization by the Company or its authorized TPA, ... Servicing of claims, i.e., claim admissions and assessments, under this Policy by way of preauthorization of cashless treatment or processing of claims other than cashless claims or both ... The services offered by a TPA shall not include:\ni. Claim settlement and claim rejection.","sources":[{"clause":"15(II)(b)(ii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-ii"},{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":false,"display":"No, Individual basis only","note":null,"quote":"Coverage Basis | Individual basis only ... Sum insured | On Individual basis — SI shall apply to each individual member","sources":[{"clause":"15(II)(b)(xiv)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006#c-15-ii-b-xiv"}],"law":[]}],"documents":[{"kind":"wording","label":"Zuno Empower Health Policy wording","pages":27,"fetched_at":"2026-10-17 20:04:22+00","source_url":"https://cms.hizuno.com/uploads/Zuno_General_Insurance_Empower_Health_Policy_wordings_V_1_1_6b5474ee7a.pdf?updated_at=2024-09-25T12:23:23.692Z","url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18006"},{"kind":"wording","label":"Zuno General Insurance Empower Health Policy wordings V-1.1","pages":27,"fetched_at":"2026-10-17 20:07:34+00","source_url":"https://cms.hizuno.com/uploads/Zuno_General_Insurance_Empower_Health_Policy_wordings_V_1_1_28dd65fbeb.pdf?updated_at=2026-03-15T17:07:19.288Z","url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18058"},{"kind":"prospectus","label":"Zuno General Insurance Empower Health Prospectus V-1.0","pages":22,"fetched_at":"2026-10-17 20:07:27+00","source_url":"https://cms.hizuno.com/uploads/Zuno_General_Insurance_Empower_Health_Prospectus_V_1_0_4263a81e7b.pdf?updated_at=2026-03-15T17:07:19.698Z","url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/18053"},{"kind":"cis","label":"Zuno Empower Health CIS V-1.1","pages":12,"fetched_at":"2026-10-17 20:03:12+00","source_url":"https://cms.hizuno.com/uploads/Zuno_Empower_Health_CIS_V_1_1_d169ae029e.pdf?updated_at=2026-03-15T17:07:18.905Z","url":"https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223/document/17972"}],"versions":[{"uin":"ZUNHLIP26047V022526","version":null,"approved_on":null},{"uin":"ZUNHLIP23204V012223","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Zuno General Insurance official website","url":"https://www.hizuno.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Health claims","url":"https://www.hizuno.com/health-insurance/health-claim","note":null},{"purpose":"claim","kind":"insurer","name":"Motor claims","url":"https://www.hizuno.com/claims-motor","note":null},{"purpose":"claim","kind":"insurer","name":"Other claims","url":"https://www.hizuno.com/other-claims","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Health renewal","url":"https://www.hizuno.com/renewals/health-renewal","note":null},{"purpose":"renew","kind":"insurer","name":"Motor renewal","url":"https://www.hizuno.com/renewals/motor-renewal","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Zuno Empower Health (UIN ZUNHLIP23204V012223), IndiaInsurances, https://indiainsurances.com/policy/zuno-general-insurance/zuno-empower-health-zunhlip23204v012223"}